Use of letrozole after aromatase inhibitor-based therapy (NRG Oncology/NSABP B-42): a randomised, double-blind, placebo-controlled phase 3 trial

At median follow-up of 6.9 years, RCT (n=3966) reported that letrozole treatment did not improve disease-free survival after 5 years of aromatase inhibitor-based therapy (292 disease-free survival events with letrozole vs 339 with placebo; HR 0.85, 95% CI 0.73–0.999; p=0.048).

A related editorial discusses the importance of competing risks when making treatment decisions about the duration of adjuvant endocrine therapy.

 

The author notes that “the benefit of extended therapy is likely to be meaningful in patients at higher risk of recurrence (eg, those with nodal involvement or genomic risk signatures for late relapse) and in those who are less likely to have substantial competing risks of death (eg, younger patients and those without comorbidities, especially cardiovascular disease).”